Indigenous health: Time for top-down change?

A year after the Truth and Reconciliation Commission’s call to action, public health experts say indigenous health won’t improve without major system change. Last June, the commission issued a comprehensive treatment plan for healing the trauma inflicted on indigenous communities under Canada’s residential schools system — but not much has happened. Eight of the commission’s 94 recommendations directly addressed health care. So what’s the hold up on high-level change? That question dominated the recent Public Health 2016 conference in Toronto. Speakers described persistent inequity and inaction across the health system, from research to medical training to hospital care. “The common response is to deny that the problem lies in the structures,” said Charlotte Loppie, director of the Centre for Indigenous Research and Community-led Engagement at the University of Victoria in British Columbia. She argued that it’s a mistake to see “colonization” as something that happened in the past. “It’s about the control that some people have over other people, which obviously continues today in the health policies and programs that are developed and expanded on indigenous communities, rather than with those communities.”